Factors Associated with Activity of Systemic Lupus Erythematosus in End-Stage Renal Disease

Translated title of the contribution: Factors Associated with Activity of Systemic Lupus Erythematosus in End-Stage Renal Disease

Luis Alonso González Naranjo, Libia María Rodríguez Padilla, Luis Alberto Ramírez Gómez

Research output: Contribution to journalArticle in an indexed scientific journalpeer-review

2 Scopus citations

Abstract

Objective the activity of systemic lupus erythematosus (SLE) tends to decline in patients who develop end-stage renal disease (ESRD). However, extrarenal activity is not uncommon, particularly during the first few years of dialysis. We studied the clinical course and assessed the SLE activity in patients with ESRD on dialysis for more than six months. The objective of this study was to identify factors associated with postdialysis activity. Methods fifteen patients with SLE who were given maintenance dialysis in our center from 2000 to 2007 were examined retrospectively. Their clinical characteristics, serological markers of disease activity and disease activity as per systemic lupus erythematosus disease activity (SLEDAI) were reviewed. Patients with and without postdialysis lupus flares were compared. Results the time between SLE diagnosis and the onset of dialysis was 40.3 months (6.3-84.3) and the duration of dialysis was 21.8 months (12.0-40.0). Eight patients experienced 9 lupus postdialysis flares. Four flares (44.4%) occurred within the first year of dialysis. Compared with the other 7 patients who had no flares during dialysis, patients with flares were younger at the onset of dialysis [22.4 years (17.9 – 24.9) vs 30.6 years (26.2 – 40.1); p = 0.021] and had serum levels of C3 significantly lower at the onset of dialysis [63.5 mg/dl (57.5 – 67.5) vs 90 mg/dl (87.5 – 105), p = 0.006]. Conclusion lupus activity does not always “burn out” in patients who progress to ESRD. Younger patients at the onset of dialysis and lower levels of C3 at the start of dialysis may have higher risk of postdialysis lupus flare. SLE patients on dialysis should be carefully followed up by clinical and serological monitoring, particularly in potential renal transplant recipients.

Translated title of the contributionFactors Associated with Activity of Systemic Lupus Erythematosus in End-Stage Renal Disease
Original languageEnglish
Pages (from-to)265-275
Number of pages11
JournalRevista Colombiana de Reumatologia
Volume16
Issue number3
DOIs
StatePublished - 1 Sep 2009
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2009 Asociación Colombiana de Reumatología

Keywords

  • dialysis
  • disease activity
  • end-stage renal disease.
  • lupus nephritis
  • systemic lupus erythematosus

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